Theoretically reduces gastric side effects such as ulceration compared with NSAIDS and should be used with caution in those with ischaemic heart disease as it may increase the risk of myocardial infarction but this is still under investigation
- Highly selective COX-2 inhibitor
- Reduced peptic ulcer disease - safety is a main selling point
- More evidence that causes prothrombotic state
- Sulphonamide - may cause rash
- NO effect on platelets and no cardioprotection
- COX-1: Homeostasis e.g. gastroprotection "good" producing prostacyclin and thromboxane
- COX-2 : Inflammatory mediators "bad"
- COX-2 inhibition x 10-20 times COX-1 inhibition
- Rheumatoid and osteoarthritis, Ankylosing spondylitis
- Menstrual related pain, Familial adenomatous polyposis - reduces polyps
- Celecoxib 100 mg -200 mg bd PO. Use lowest effective/shortest duration dose.
- Aspirin offsets any gastroprotection
- Increases toxicity of methotrexate
- Risk of renal impairment with ACEI, AT2 blockers or Ciclosporin.
- May cause a prothrombotic state
- Can cause renal toxicity, Cardiac failure - fluid retention
- Hypertension, Ischaemic heart disease
- Prothrombotic state, Hypertension, oedema, angina, cough, diarrhoea